Provider Demographics
NPI:1962441006
Name:DUNHAM, MEREDITH INMAN (NP)
Entity Type:Individual
Prefix:
First Name:MEREDITH
Middle Name:INMAN
Last Name:DUNHAM
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 710
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37070-0710
Mailing Address - Country:US
Mailing Address - Phone:615-859-1440
Mailing Address - Fax:615-859-0145
Practice Address - Street 1:740 CONFERENCE DR
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-1915
Practice Address - Country:US
Practice Address - Phone:615-859-1440
Practice Address - Fax:615-859-0145
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN139970363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3649048Medicare PIN
Q27007Medicare UPIN